Dear Katie,
The idea of "commuter surgeries" fills me with horror if contemplated as part of GMS. After seeing 70 patients yesterday (in order to fulfil a practice guarantee to give 'urgent' requests a same-day appointment), I think we need to spell out exactly what GMS can and cannot provide.
There is a place for convenience healthcare:- surgeries in supermarkets, home-delivery scripts, 24hr telephone advice for routine enquiries - the list is endless.
Unfortunately this is not what current general practice can provide with existing funds and manpower.
We have to inform the public that '24hr drive-thru' medicine comes at a price, and the NHS cannot afford it.
If we can stem the flow of increasing patient demand even at a small level, we may stand a chance in continuing to practise quality primary care with increasingly limited resources.
Anita
Dr A D Malkhandi GP
-----Original Message-----
From: Katie Law [SMTP:[log in to unmask]]
Sent: Wednesday, July 08, 1998 9:28 PM
To: [log in to unmask]
Subject: Evening and weekend surgeries
In one of those freebie newspapers today, it lists "further initiatives"
which include:
" A second wave of NHS(Primary Care Act) Pilots to come into
effect on 1 oct 1999, which will pioneer the delivery of services to
patients in a flexible way - for example, through evening or weekend
surgeries "
Am I alone in thinking this is *not a good thing* ?
I was delighted when the local Tesco's decided it was no longer viable
to stay open all night. Patients already have a tendency to think along
the lines of " if the shops are open why isn't everything else" .
Don't get me wrong, I do believe we are there to serve the patients.
But it is not in anyone's best interests to have 24 hour full services.
Providing evening and weekend surgeries is the thin end of another wedge
- soon it will become late evening, mid-night etc. and at what cost?
There may be a few doctors willing to do this for personal reasons
(eg. childcare), but if they do, it will soon become expected, and those
of us who value evenings at home will find ourselves pressured to follow
suite.
Children who can always ask a parent how to spell a word may never learn
to use a dictionary.
Patients who have immediate access to doctors may never learn to think
for themselves.
Why should we have to work all hours so other people don't have to put
themselves out - for what is actually their problem ?
When we are sick do we not have to take time off work *and* pay for a
locum to do our work?
If a patient is sick and it is important enough then surely they should
take the time out of work or commitments to see a doctor?
There are appropriate out-of-hours emergency services available in this
country almost unmatched by any other.
It would be a retrograde step to provide full GMS over 24 hours.
If that becomes expected, I will not stay in general practice.
KT
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